Final Report on the COVID-19 Pandemic in Korea: How Health Disparity Has Been Changed According to the Pandemic Stage

Background: As the coronavirus disease (COVID-19) pandemic nears its end, a comprehensive report is required to sum up the impact of COVID-19. This study aimed to examine health outcomes and disparities based on socioeconomic status during the COVID-19 pandemic in Korea, while identifying associated risk factors for hospitalisation and mortality.Methods: This nationwide, retrospective study examined a cohort of people with and without COVID-19 in Korea from 1 January 2020 to 31 December 2022, divided into four stages. Incidence (per 100,000), hospitalisation (per 100,000), mortality (per 100,000), and case fatality (per100,000) were calculated. Multivariate logistic regression was performed to identify risk factors for hospitalisation and mortalityFindings: Throughout the study period, the incidence was 40,601 per 100,000 population, mortality 105 per 100,000 and case fatality was 259 per 100,000 cases. There were many new cases in stage three, and 8,979,635 (17.5%) in stage four. The fifth quintile had the lowest incidence (32,737 per 100,000), but the highest hospitalisation (5,663 cases per 100,000), mortality (498 per 100,000), and case fatality (1521 per 100,000). Male sex, older age, lower economic status, living in other areas, a high Charlson comorbidity index, and individuals with disabilities had a higher risk of hospitalisation and death. Vaccination reduced the risk of death.Interpretation: As the pandemic progressed, there was a surge in incidence, hospitalisation, and mortality, widening disparities related to economic status and disability. Despite these disparities, Korea has maintained a low case-fatality rate across all economic groups.Funding: This research did not receive any funding.Declaration of Interest: The authors declare that there are no conflicts of interests.Ethical Approval: The Institutional Review Board (IRB) of Seoul National University Bundang Hospital approved this study (IRB number X-2207-768-901).